Provider Demographics
NPI:1447267786
Name:ROSENBERG, LUCY GOMEZ (DC)
Entity type:Individual
Prefix:DR
First Name:LUCY
Middle Name:GOMEZ
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LUCY
Other - Middle Name:
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3450 ACWORTH DUE WEST RD NW
Mailing Address - Street 2:STE 330
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-1001
Mailing Address - Country:US
Mailing Address - Phone:678-574-5227
Mailing Address - Fax:678-574-5223
Practice Address - Street 1:3450 ACWORTH DUE WEST RD NW
Practice Address - Street 2:STE 330
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-1001
Practice Address - Country:US
Practice Address - Phone:678-574-5227
Practice Address - Fax:678-574-5223
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007742111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor